Improving Care Pathways for Acute Coronary Syndrome: Patients Undergoing Percutaneous Coronary Intervention
Acute coronary syndrome (ACS) admissions are common and costly. The association between comprehensive ACS care pathways, outcomes, and costs are lacking. From 434,172 low-risk, uncomplicated ACS patients eligible for early discharge (STEMI 35%, UA/NSTEMI 65%) from the Premier database, we identified...
Gespeichert in:
| Veröffentlicht in: | The American journal of cardiology 2020-02, Vol.125 (3), p.354-361 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 361 |
|---|---|
| container_issue | 3 |
| container_start_page | 354 |
| container_title | The American journal of cardiology |
| container_volume | 125 |
| creator | Amin, Amit P. Spertus, John A. Kulkarni, Hemant McNeely, Christian Rao, Sunil V. Pinto, Duane House, John A. Messenger, John C. Bach, Richard G. Goyal, Abhinav Shroff, Adhir Pancholy, Samir Bradley, Steven M. Gluckman, Ty J. Maddox, Thomas M. Wasfy, Jason H. Masoudi, Frederick A. |
| description | Acute coronary syndrome (ACS) admissions are common and costly. The association between comprehensive ACS care pathways, outcomes, and costs are lacking. From 434,172 low-risk, uncomplicated ACS patients eligible for early discharge (STEMI 35%, UA/NSTEMI 65%) from the Premier database, we identified ACS care pathways, by stratifying low-risk, uncomplicated STEMI and UA/NSTEMI patients by access site for PCI (trans-radial intervention [TRI] vs transfemoral intervention [TFI]) and by length of stay (LOS). Associations with costs and outcomes (death, bleeding, acute kidney injury, and myocardial infarction at 1-year) were tested using hierarchical, mixed-effects regression, and projections of cost savings with change in care pathways were obtained using modeling. In low-risk uncomplicated STEMI patients, compared with TFI and LOS ≥3 days, a strategy of TRI with LOS |
| doi_str_mv | 10.1016/j.amjcard.2019.10.019 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7809633</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S000291491931166X</els_id><sourcerecordid>2322806654</sourcerecordid><originalsourceid>FETCH-LOGICAL-c561t-556e1d97806f37422e48e2b2845d7df5516fd06dd19ccc3d007f1fb8e9d4440e3</originalsourceid><addsrcrecordid>eNqFkU2P0zAQhi0EYsvCTwBF4sIlxXYcJ-YAWlV8VFqJlWDPlmtPug6NXeykqP-eiVqWjwunkWeedz78EvKc0SWjTL7ul2borUluySlTmFtieEAWrG1UyRSrHpIFpZSXigl1QZ7k3OOTsVo-JhcVaxnnXCzIt_WwT_Hgw7ZYmQTFjRnvfphjLrqYiis7jVCsYorBpGPx5RhcigO8mSkPYczFbXCQtnGW30BC3ASIU_6tWYcR0gFZH8NT8qgzuwzPzvGS3H54_3X1qbz-_HG9uroubS3ZWNa1BOZU01LZVY3gHEQLfMNbUbvGdXXNZOeodI4pa23lKG061m1aUE4IQaG6JG9PfffTZgBncXoyO71PfsCVdDRe_10J_k5v40HjSCWrChu8OjdI8fsEedSDzxZ2u9N1mlec43ayFoi-_Aft45QCnodUJWTDGyqRqk-UTTHnBN39Mozq2U7d67OderZzTmNA3Ys_L7lX_fIPgXcnAPA_Dx6SzhadseB8AjtqF_1_RvwEFte1wg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2334672706</pqid></control><display><type>article</type><title>Improving Care Pathways for Acute Coronary Syndrome: Patients Undergoing Percutaneous Coronary Intervention</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Amin, Amit P. ; Spertus, John A. ; Kulkarni, Hemant ; McNeely, Christian ; Rao, Sunil V. ; Pinto, Duane ; House, John A. ; Messenger, John C. ; Bach, Richard G. ; Goyal, Abhinav ; Shroff, Adhir ; Pancholy, Samir ; Bradley, Steven M. ; Gluckman, Ty J. ; Maddox, Thomas M. ; Wasfy, Jason H. ; Masoudi, Frederick A.</creator><creatorcontrib>Amin, Amit P. ; Spertus, John A. ; Kulkarni, Hemant ; McNeely, Christian ; Rao, Sunil V. ; Pinto, Duane ; House, John A. ; Messenger, John C. ; Bach, Richard G. ; Goyal, Abhinav ; Shroff, Adhir ; Pancholy, Samir ; Bradley, Steven M. ; Gluckman, Ty J. ; Maddox, Thomas M. ; Wasfy, Jason H. ; Masoudi, Frederick A.</creatorcontrib><description>Acute coronary syndrome (ACS) admissions are common and costly. The association between comprehensive ACS care pathways, outcomes, and costs are lacking. From 434,172 low-risk, uncomplicated ACS patients eligible for early discharge (STEMI 35%, UA/NSTEMI 65%) from the Premier database, we identified ACS care pathways, by stratifying low-risk, uncomplicated STEMI and UA/NSTEMI patients by access site for PCI (trans-radial intervention [TRI] vs transfemoral intervention [TFI]) and by length of stay (LOS). Associations with costs and outcomes (death, bleeding, acute kidney injury, and myocardial infarction at 1-year) were tested using hierarchical, mixed-effects regression, and projections of cost savings with change in care pathways were obtained using modeling. In low-risk uncomplicated STEMI patients, compared with TFI and LOS ≥3 days, a strategy of TRI with LOS <3 days and TFI with LOS <3 days were associated with cost savings of $6,206 and $4,802, respectively. Corresponding cost savings for UA/NSTEMI patients were $7,475 and $6,169, respectively. These care-pathways did not show an excess risk of adverse outcomes. We estimated that >$300 million could be saved if prevalence of the TRI with LOS <3 days and TFI with LOS <3 days strategies are modestly increased to 20% and 70%, respectively. In conclusion, we demonstrate the potential opportunity of cost savings by repositioning ACS care pathways in low-risk and uncomplicated ACS patients, toward transradial access and a shorter LOS without an increased risk of adverse outcomes.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2019.10.019</identifier><identifier>PMID: 31812224</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Acute Coronary Syndrome - economics ; Acute Coronary Syndrome - surgery ; Acute coronary syndromes ; Angioplasty ; Bleeding ; Cost engineering ; Cost reduction ; Costs and Cost Analysis ; Efficiency ; Female ; Follow-Up Studies ; Forecasting ; Health Care Costs - trends ; Health care policy ; Hospital costs ; Humans ; Length of Stay - trends ; Male ; Medicaid ; Middle Aged ; Morbidity ; Myocardial infarction ; Patients ; Percutaneous Coronary Intervention ; Quality Improvement - economics ; Registries ; Retrospective Studies ; Risk ; Treatment Outcome ; United States ; Variables</subject><ispartof>The American journal of cardiology, 2020-02, Vol.125 (3), p.354-361</ispartof><rights>2019 Elsevier Inc.</rights><rights>Copyright © 2019 Elsevier Inc. All rights reserved.</rights><rights>2019. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c561t-556e1d97806f37422e48e2b2845d7df5516fd06dd19ccc3d007f1fb8e9d4440e3</citedby><cites>FETCH-LOGICAL-c561t-556e1d97806f37422e48e2b2845d7df5516fd06dd19ccc3d007f1fb8e9d4440e3</cites><orcidid>0000-0002-6286-2349 ; 0000-0003-4006-6760 ; 0000-0002-2839-2611</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S000291491931166X$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31812224$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Amin, Amit P.</creatorcontrib><creatorcontrib>Spertus, John A.</creatorcontrib><creatorcontrib>Kulkarni, Hemant</creatorcontrib><creatorcontrib>McNeely, Christian</creatorcontrib><creatorcontrib>Rao, Sunil V.</creatorcontrib><creatorcontrib>Pinto, Duane</creatorcontrib><creatorcontrib>House, John A.</creatorcontrib><creatorcontrib>Messenger, John C.</creatorcontrib><creatorcontrib>Bach, Richard G.</creatorcontrib><creatorcontrib>Goyal, Abhinav</creatorcontrib><creatorcontrib>Shroff, Adhir</creatorcontrib><creatorcontrib>Pancholy, Samir</creatorcontrib><creatorcontrib>Bradley, Steven M.</creatorcontrib><creatorcontrib>Gluckman, Ty J.</creatorcontrib><creatorcontrib>Maddox, Thomas M.</creatorcontrib><creatorcontrib>Wasfy, Jason H.</creatorcontrib><creatorcontrib>Masoudi, Frederick A.</creatorcontrib><title>Improving Care Pathways for Acute Coronary Syndrome: Patients Undergoing Percutaneous Coronary Intervention</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Acute coronary syndrome (ACS) admissions are common and costly. The association between comprehensive ACS care pathways, outcomes, and costs are lacking. From 434,172 low-risk, uncomplicated ACS patients eligible for early discharge (STEMI 35%, UA/NSTEMI 65%) from the Premier database, we identified ACS care pathways, by stratifying low-risk, uncomplicated STEMI and UA/NSTEMI patients by access site for PCI (trans-radial intervention [TRI] vs transfemoral intervention [TFI]) and by length of stay (LOS). Associations with costs and outcomes (death, bleeding, acute kidney injury, and myocardial infarction at 1-year) were tested using hierarchical, mixed-effects regression, and projections of cost savings with change in care pathways were obtained using modeling. In low-risk uncomplicated STEMI patients, compared with TFI and LOS ≥3 days, a strategy of TRI with LOS <3 days and TFI with LOS <3 days were associated with cost savings of $6,206 and $4,802, respectively. Corresponding cost savings for UA/NSTEMI patients were $7,475 and $6,169, respectively. These care-pathways did not show an excess risk of adverse outcomes. We estimated that >$300 million could be saved if prevalence of the TRI with LOS <3 days and TFI with LOS <3 days strategies are modestly increased to 20% and 70%, respectively. In conclusion, we demonstrate the potential opportunity of cost savings by repositioning ACS care pathways in low-risk and uncomplicated ACS patients, toward transradial access and a shorter LOS without an increased risk of adverse outcomes.</description><subject>Acute Coronary Syndrome - economics</subject><subject>Acute Coronary Syndrome - surgery</subject><subject>Acute coronary syndromes</subject><subject>Angioplasty</subject><subject>Bleeding</subject><subject>Cost engineering</subject><subject>Cost reduction</subject><subject>Costs and Cost Analysis</subject><subject>Efficiency</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Forecasting</subject><subject>Health Care Costs - trends</subject><subject>Health care policy</subject><subject>Hospital costs</subject><subject>Humans</subject><subject>Length of Stay - trends</subject><subject>Male</subject><subject>Medicaid</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Myocardial infarction</subject><subject>Patients</subject><subject>Percutaneous Coronary Intervention</subject><subject>Quality Improvement - economics</subject><subject>Registries</subject><subject>Retrospective Studies</subject><subject>Risk</subject><subject>Treatment Outcome</subject><subject>United States</subject><subject>Variables</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkU2P0zAQhi0EYsvCTwBF4sIlxXYcJ-YAWlV8VFqJlWDPlmtPug6NXeykqP-eiVqWjwunkWeedz78EvKc0SWjTL7ul2borUluySlTmFtieEAWrG1UyRSrHpIFpZSXigl1QZ7k3OOTsVo-JhcVaxnnXCzIt_WwT_Hgw7ZYmQTFjRnvfphjLrqYiis7jVCsYorBpGPx5RhcigO8mSkPYczFbXCQtnGW30BC3ASIU_6tWYcR0gFZH8NT8qgzuwzPzvGS3H54_3X1qbz-_HG9uroubS3ZWNa1BOZU01LZVY3gHEQLfMNbUbvGdXXNZOeodI4pa23lKG061m1aUE4IQaG6JG9PfffTZgBncXoyO71PfsCVdDRe_10J_k5v40HjSCWrChu8OjdI8fsEedSDzxZ2u9N1mlec43ayFoi-_Aft45QCnodUJWTDGyqRqk-UTTHnBN39Mozq2U7d67OderZzTmNA3Ys_L7lX_fIPgXcnAPA_Dx6SzhadseB8AjtqF_1_RvwEFte1wg</recordid><startdate>20200201</startdate><enddate>20200201</enddate><creator>Amin, Amit P.</creator><creator>Spertus, John A.</creator><creator>Kulkarni, Hemant</creator><creator>McNeely, Christian</creator><creator>Rao, Sunil V.</creator><creator>Pinto, Duane</creator><creator>House, John A.</creator><creator>Messenger, John C.</creator><creator>Bach, Richard G.</creator><creator>Goyal, Abhinav</creator><creator>Shroff, Adhir</creator><creator>Pancholy, Samir</creator><creator>Bradley, Steven M.</creator><creator>Gluckman, Ty J.</creator><creator>Maddox, Thomas M.</creator><creator>Wasfy, Jason H.</creator><creator>Masoudi, Frederick A.</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7Z</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-6286-2349</orcidid><orcidid>https://orcid.org/0000-0003-4006-6760</orcidid><orcidid>https://orcid.org/0000-0002-2839-2611</orcidid></search><sort><creationdate>20200201</creationdate><title>Improving Care Pathways for Acute Coronary Syndrome: Patients Undergoing Percutaneous Coronary Intervention</title><author>Amin, Amit P. ; Spertus, John A. ; Kulkarni, Hemant ; McNeely, Christian ; Rao, Sunil V. ; Pinto, Duane ; House, John A. ; Messenger, John C. ; Bach, Richard G. ; Goyal, Abhinav ; Shroff, Adhir ; Pancholy, Samir ; Bradley, Steven M. ; Gluckman, Ty J. ; Maddox, Thomas M. ; Wasfy, Jason H. ; Masoudi, Frederick A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c561t-556e1d97806f37422e48e2b2845d7df5516fd06dd19ccc3d007f1fb8e9d4440e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Acute Coronary Syndrome - economics</topic><topic>Acute Coronary Syndrome - surgery</topic><topic>Acute coronary syndromes</topic><topic>Angioplasty</topic><topic>Bleeding</topic><topic>Cost engineering</topic><topic>Cost reduction</topic><topic>Costs and Cost Analysis</topic><topic>Efficiency</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Forecasting</topic><topic>Health Care Costs - trends</topic><topic>Health care policy</topic><topic>Hospital costs</topic><topic>Humans</topic><topic>Length of Stay - trends</topic><topic>Male</topic><topic>Medicaid</topic><topic>Middle Aged</topic><topic>Morbidity</topic><topic>Myocardial infarction</topic><topic>Patients</topic><topic>Percutaneous Coronary Intervention</topic><topic>Quality Improvement - economics</topic><topic>Registries</topic><topic>Retrospective Studies</topic><topic>Risk</topic><topic>Treatment Outcome</topic><topic>United States</topic><topic>Variables</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Amin, Amit P.</creatorcontrib><creatorcontrib>Spertus, John A.</creatorcontrib><creatorcontrib>Kulkarni, Hemant</creatorcontrib><creatorcontrib>McNeely, Christian</creatorcontrib><creatorcontrib>Rao, Sunil V.</creatorcontrib><creatorcontrib>Pinto, Duane</creatorcontrib><creatorcontrib>House, John A.</creatorcontrib><creatorcontrib>Messenger, John C.</creatorcontrib><creatorcontrib>Bach, Richard G.</creatorcontrib><creatorcontrib>Goyal, Abhinav</creatorcontrib><creatorcontrib>Shroff, Adhir</creatorcontrib><creatorcontrib>Pancholy, Samir</creatorcontrib><creatorcontrib>Bradley, Steven M.</creatorcontrib><creatorcontrib>Gluckman, Ty J.</creatorcontrib><creatorcontrib>Maddox, Thomas M.</creatorcontrib><creatorcontrib>Wasfy, Jason H.</creatorcontrib><creatorcontrib>Masoudi, Frederick A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Biochemistry Abstracts 1</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Amin, Amit P.</au><au>Spertus, John A.</au><au>Kulkarni, Hemant</au><au>McNeely, Christian</au><au>Rao, Sunil V.</au><au>Pinto, Duane</au><au>House, John A.</au><au>Messenger, John C.</au><au>Bach, Richard G.</au><au>Goyal, Abhinav</au><au>Shroff, Adhir</au><au>Pancholy, Samir</au><au>Bradley, Steven M.</au><au>Gluckman, Ty J.</au><au>Maddox, Thomas M.</au><au>Wasfy, Jason H.</au><au>Masoudi, Frederick A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Improving Care Pathways for Acute Coronary Syndrome: Patients Undergoing Percutaneous Coronary Intervention</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2020-02-01</date><risdate>2020</risdate><volume>125</volume><issue>3</issue><spage>354</spage><epage>361</epage><pages>354-361</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><abstract>Acute coronary syndrome (ACS) admissions are common and costly. The association between comprehensive ACS care pathways, outcomes, and costs are lacking. From 434,172 low-risk, uncomplicated ACS patients eligible for early discharge (STEMI 35%, UA/NSTEMI 65%) from the Premier database, we identified ACS care pathways, by stratifying low-risk, uncomplicated STEMI and UA/NSTEMI patients by access site for PCI (trans-radial intervention [TRI] vs transfemoral intervention [TFI]) and by length of stay (LOS). Associations with costs and outcomes (death, bleeding, acute kidney injury, and myocardial infarction at 1-year) were tested using hierarchical, mixed-effects regression, and projections of cost savings with change in care pathways were obtained using modeling. In low-risk uncomplicated STEMI patients, compared with TFI and LOS ≥3 days, a strategy of TRI with LOS <3 days and TFI with LOS <3 days were associated with cost savings of $6,206 and $4,802, respectively. Corresponding cost savings for UA/NSTEMI patients were $7,475 and $6,169, respectively. These care-pathways did not show an excess risk of adverse outcomes. We estimated that >$300 million could be saved if prevalence of the TRI with LOS <3 days and TFI with LOS <3 days strategies are modestly increased to 20% and 70%, respectively. In conclusion, we demonstrate the potential opportunity of cost savings by repositioning ACS care pathways in low-risk and uncomplicated ACS patients, toward transradial access and a shorter LOS without an increased risk of adverse outcomes.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>31812224</pmid><doi>10.1016/j.amjcard.2019.10.019</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-6286-2349</orcidid><orcidid>https://orcid.org/0000-0003-4006-6760</orcidid><orcidid>https://orcid.org/0000-0002-2839-2611</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0002-9149 |
| ispartof | The American journal of cardiology, 2020-02, Vol.125 (3), p.354-361 |
| issn | 0002-9149 1879-1913 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7809633 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Acute Coronary Syndrome - economics Acute Coronary Syndrome - surgery Acute coronary syndromes Angioplasty Bleeding Cost engineering Cost reduction Costs and Cost Analysis Efficiency Female Follow-Up Studies Forecasting Health Care Costs - trends Health care policy Hospital costs Humans Length of Stay - trends Male Medicaid Middle Aged Morbidity Myocardial infarction Patients Percutaneous Coronary Intervention Quality Improvement - economics Registries Retrospective Studies Risk Treatment Outcome United States Variables |
| title | Improving Care Pathways for Acute Coronary Syndrome: Patients Undergoing Percutaneous Coronary Intervention |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-31T16%3A58%3A31IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Improving%20Care%20Pathways%20for%20Acute%20Coronary%20Syndrome:%20Patients%20Undergoing%20Percutaneous%20Coronary%20Intervention&rft.jtitle=The%20American%20journal%20of%20cardiology&rft.au=Amin,%20Amit%20P.&rft.date=2020-02-01&rft.volume=125&rft.issue=3&rft.spage=354&rft.epage=361&rft.pages=354-361&rft.issn=0002-9149&rft.eissn=1879-1913&rft_id=info:doi/10.1016/j.amjcard.2019.10.019&rft_dat=%3Cproquest_pubme%3E2322806654%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2334672706&rft_id=info:pmid/31812224&rft_els_id=S000291491931166X&rfr_iscdi=true |